Below is a summary of what we found at this inspection. The summary is based on our observations during the inspection. We spoke with eight of the fourteen people who used the service, two staff, the deputy manager and visiting professionals. We looked at four people's care records as well as other records related to the running of the service.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with told us they felt safe. One person said: 'It's a lovely home, great staff, very helpful I couldn't be happier'. People who used the service and staff told us that people's care was regularly discussed and planned with them. This meant that staff had the information they needed to keep people safe. We saw for example that people had the correct equipment they needed to support them and staff had been trained to use this safely.
The home had policies and procedures in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do. No DoLS applications had needed to be submitted. The deputy manager and provider understood when an application should be made, and how to submit one. This meant that people will be safeguarded as required.
We saw that there was sufficient staff to ensure people's care needs were taken into account. Staff were supported so that they had the qualifications, skills, and support they required. Staff told us it was: "A lovely place to work" and that: "We have great support and guidance so that we know exactly what to do and do things safely". This helped ensure that people's needs are always met.
We saw that systems were in place to make sure that staff learned from events such as falls, accidents or complaints. This had helped the service to promote the safety of people for example by providing detailed plans about the equipment people needed and how this should be used.
Is the service effective?
People's health and care needs were assessed with them, and other professionals contributed towards information in their plans of care. Specialist needs had been identified in care plans where required. We saw that people had a one to one meeting regularly to discuss their needs to ensure the care being provided was effective. Records of these meetings showed that relatives were very positive about the care provided. A visiting professional said: 'This is one of the better homes we visit with regard to staff being aware of people's fragile skin and alerting us'.
We found that people's health care needs were addressed in a timely manner and staff had the right knowledge and skills to understand people's needs and when to seek advice. One staff member told us: 'We have regular meetings with people and their families so we know what they need and what makes them happy'. Another staff member said: 'Care plans and risk assessments are up to date, regularly reviewed and we discuss any issues that we need. This means we can plan for people on an individual basis'.
We saw that staff provided the care that people needed. One person using the service told us: 'I have a problem with my legs; the staff are very good help me to keep them up'. This meant people were supported in a way that met their needs.
Is the service caring?
We saw staff interact with people in a very gentle and caring way. Staff were aware of and responded to people who could not always initiate conversation. We saw staff sit, talk and joke with people, we saw they were tactile and held people's hands to give reassurance. One person told us: 'When I'm walking I like to know they are with me in case I fall. They take their time, never rush me and are so kind'. We found from our observations that staff demonstrated a willingness to help people and were kind and gentle.
Is the service responsive?
We found that the provider had regularly asked and acted upon the comments and views of people who used the service and their relative's. We saw this had led to improvements in areas such as decoration of the home, looking after people's laundry and replacing seating. We saw staff were responsive to people's choices about where they sat, what they ate and what activities they wished to pursue. We saw staff made the time to respond to people's emotional needs by sitting with them, chatting or doing a one to one activity. This was particularly important to those people who sometimes got confused and could not cope with group activities. This meant people had a stimulation suited to their needs.
Is the service well-led?
The service had a registered manager although the deputy manager managed the home on a daily basis. We saw that systems were in place to ensure good standards of care. For example staff were regularly trained, well supervised and had the support they needed to provide a good standard of care.
Staff had opportunities to discuss and review their performance. Improvements to the way they worked had been made as a result of this. For example systems had been put in place that helped staff to identify and use equipment safely.
We saw people had care plans that were detailed, identified any risks to their health or safety and reflected their personal preferences. This meant staff had good guidance on how to meet people's needs.
We saw that a number of audits were carried out in order to assess the quality of care provided. The provider had included external advice to ensure the recommendations of health professionals was considered and followed to meet people's needs.